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A chance to get poor adults back to the dentist

Post by TNT Editorial Board / The News Tribune on March 17, 2013 at 3:47 pm |
March 15, 2013 3:49 pm

This editorial will appear in Monday’s print edition.

Since the Great Recession hit five years ago, the Legislature has had to do dumb things with money – short-term spending cuts that, long term, were bound to cost more money than they saved.

One of these forced errors was the elimination of Medicaid dental coverage for more than 400,000 poor adults in recent years. For every dollar saved, the state forfeited another dollar in federal matching funds – and set itself up for higher medical expenses down the road.

It’s now time to reverse that penny-wise decision. With the Affordable Care Act about to supplement state Medicaid spending with federal, the restoration of dental care would leverage far more federal dollars than it would cost.

Dental infections are like other infections: Let them fester, and the problems only get bigger and more expensive.

After the Medicaid cut in 2011, adults who’d lost their coverage either had to seek charity care or go to the emergency room when they got a toothache.

Pain in the jaws and the teeth can be symptoms of nasty conditions, including abscesses turning into massive bacterial infections. Emergency room staffs can provide painkillers and antibiotics, but they can’t treat the underlying dental diseases.

Diabetes is the best illustration of pay-now-or-pay-more-later.

Gum disease, untreated, wreaks havoc on diabetics. Without dental care, researchers have found that people suffer higher rates of kidney and heart disease, stroke, and blindness.

A broad study released last April estimated that treatment of periodontal disease in diabetics saved an average of $1,814 a year.

Restoring dental coverage for the excluded 450,000 Washingtonians in the next biennium would cost the state an estimated $30.8 million.

That would snag an equal amount from the federal government. It would also leverage 100 percent federal funding for 260,000 more adults who’d be brought into Medicaid next year under the Affordable Care Act. More than 700,000 low-income Washingtonians would wind up with dental insurance they otherwise wouldn’t get.

This country has historically maintained an exaggerated distinction between dental and medical care, as if teeth and jaws somehow didn’t connect to the rest of the body. It’s all health care, though, and the Legislature should grab this opportunity to offer dentistry to Washingtonians with little money.

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